NursingCenter’s In the Round

A dialog by nurses, for nurses

Another flu season is just around the corner

clock August 30, 2010 17:39 by author Lisa Bonsall, MSN, RN, CRNP

Although the H1N1 influenza pandemic has been officially declared over (you can read the statement from the World Health Organization here), it is not too soon to start thinking about the upcoming 2010-2011 flu season. Actually, during a recent visit to our local pharmacy, I noticed the sign “Flu shots available here.” Hmmm… there is a difference between thinking and doing - is it really time to vaccinate now?

Here’s what I found:

  • The 2010-2011 flu vaccine will protect against 3 flu viruses: an H3N2 virus, an influenza B virus and the H1N1 virus.
  • Routine influenza vaccination is recommended for everyone ages 6 months and older.
  • As in the past, all children aged 6 months to 8 years who receive a seasonal influenza vaccine for the first time should receive 2 doses.
  • For the 2010-2011 season, children 6 months to 8 years who did not receive at least 1 dose of an influenza A (H1N1) 2009 monovalent vaccine should receive 2 doses of a 2010-2011 seasonal influenza vaccine.
  • And lastly, yes…the Centers for Disease Control and Prevention is encouraging health care providers to begin vaccinating patients as soon as the vaccine arrives (shipments have already begun.)

You may remember from an earlier post that I never got my flu shot or H1N1 vaccine during the 2009-2010 season. The reason was simply one of convenience, or actually, inconvenience. The vaccines weren’t available when I had a visit with my physician and then there wasn't enought staff to administer the vaccines when they did become available.

I’m planning on getting vaccinated this year. How about you?


Red Book Online Influenza Resource Page from the American Academy of Pediatrics

Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010

Holistic care - exciting collaboration coming soon!

clock August 6, 2010 05:21 by author Lisa Bonsall, MSN, RN, CRNP

“This year, 2010, we celebrate the International Year of the Nurse to commemorate Florence Nightingale, the founder of modern nursing who died in 1910. We believe that Ms. Nightingale, an advocate of health, self-healing, and healthy environments, would be proud of the strides that nurses have made to promote holistic health and care around the world. In honor of the Year of the Nurse, the Editors of Holistic Nursing Practice (HNP) and Alternative Therapies in Health and Medicine (ATHM) have collaborated on their fall issues to highlight the cutting-edge contributions of nurses who work from holistic frameworks.”

This excerpt, from the editorial of Gloria F. Donnelly, PhD, RN, FAAN, Editor-in-Chief of HNP, will appear in the September issue. I’m excited to let you know that the fall issues of HNP and ATHM will be free online for 90 days! Upcoming feature articles include H1N1 Pandemics and Disease Mongering: Applying Holistic Philosophy to Counteract Fear and The Use of Complementary and Integrative Therapies in Mild to Moderate Depression.

I’ll be sure to let you know when the free issues are posted. In the meantime, three articles are available ahead of print.  Feel free to peruse these articles and let us know what you think!

H1N1 ~ Details from the past year

clock May 16, 2010 18:18 by author Lisa Bonsall, MSN, RN, CRNP

A headline from last week about determining the end of the 2009 H1N1 influenza pandemic caught my eye. Was it really officially over?

While searching for this answer or at least information about declaring the end of a pandemic, I came across a comprehensive summary of pandemic H1N1 in the May 6th issue of The New England Journal of Medicine. I thought I’d share some highlights with you:

Estimates of cases in the U.S. (as of February 2010):
*59 million illnesses
*265,000 hospitalizations
*12,000 deaths

International information:
*Almost all countries have reported cases
*More than 17,700 deaths among laboratory-confirmed cases

Hospitalization rates were highest for those younger than 5 years (especially age 1 year and younger) and lowest for those over 65 years. Certain groups have been overrepresented among those with severe 2009 H1N1 virus infection. These groups include pregnant women (especially in 2nd and 3rd trimester), women less than 2 weeks postpartum, and patients with immunosuppression or neurologic disorders. Also, severe obesity or morbid obesity has been shown to contribute to the risk of severe or fatal disease.

So, is the pandemic over? An expert panel of the World Health Organization will review the status of 2009 H1N1 influenza later this month or in early June.  I’ll keep you posted!

Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009 Influenza,
Clinical Aspects of Pandemic 2009 Influenza A (H1N1) Virus Infection
N Engl J Med 2010 362: 1708-1719

Education is good, but action is better

clock January 20, 2010 02:40 by author Lisa Bonsall, MSN, RN, CRNP

Since last April, a big part of my job has been reading, researching, and writing about H1N1 influenza. Many friends, family members, and colleagues were aware of this and came to me for information about the virus, and then, in the fall, about the H1N1 vaccine.

I’ll admit that I was skeptical about the vaccine at first; however, I made the decision to follow the recommendations of the CDC and get vaccinated. I called my doctor’s office….”No vaccine in yet”. This was the response for several weeks. In the meantime, my children got vaccinated at school (seasonal and H1N1) and my husband got both vaccines at work (he’s a respiratory therapist). We also all got....THE FLU! H1N1? Maybe.

So, here it is, January 20th, and still no vaccine for me. I contemplated skipping both my seasonal and the H1N1 vaccines this year since we are so far into flu season already. Then last week, in an open letter to the American people, the CDC reminded me (and the rest of Americans) that flu season traditionally lasts until May. In that same letter, I also learned that there are currently over 110 million doses of the H1N1 vaccine available. Great – I thought – I’ll do it! I called my primary care office to make appointments for the seasonal and H1N1 vaccines but wasn’t able to schedule them because while they do have the vaccines, they don’t have enough staff to administer them. I was instructed to call back next week.

This got me thinking... While it is great that we educate and encourage people to get vaccinated, how can we make it easier for them to do so? One colleague recently needed several vaccinations as well as a titer drawn for varicella before some upcoming travel abroad. Luckily she was able to get all of her needs met at occupational health where she works. While I am happy my colleague could get her needs met in a timely fashion, in one appointment, in a convenient setting, would this be as easy for a layperson? My husband got both his vaccines at work, during his shift – great for him, but how about the patients he cares for who have to wait for appointments and may have to schedule multiple visits to get their needs met?

While it is great that we educate our patients and the public about staying healthy, how can we improve the system?

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